Microbial Analysis Reveals Potential Therapeutic Targets for Hypopigmentation in Lichen Striatus

Image courtesy of Derm Net

In a recent study published in the Journal of the European Academy of Dermatology & Venereology earlier this month, researchers from Pusan National University in Korea shed light on a previously unexplored aspect of lichen striatus (LS)–the link between hypopigmentation and skin microbiota.

LS often presents with hypopigmentation. What sets LS apart is its higher frequency of hypopigmentation compared to other skin inflammations, affecting up to 50% of cases, with some enduring for months or even years.

Researchers focused on Cutibacterium acnes, including acne vulgaris and post-inflammatory hypopigmentation. Their hypothesized a potential association between C. acnes and the observed skin microbiota in LS patients with and without hypopigmentation.

The study involved collecting and analyzing skin samples from 18 patients with LS, 11 with hypopigmentation and 7 without, confirmed by a biopsy.

Whole genome sequencing and bioinformatics analyses revealed significant differences in the skin microbiomes, emphasizing a significant association between LS hypopigmentation and the skin microbiome.

Comparing patients with LS with and without hypopigmentation, researchers found a quadrupled presence of C. acnes in those with hypopigmentation (23.26% versus 5.29% of the entire microbiota).

“C. acnes significantly influenced the bacterial community in hypopigmented LS, holding a central position in relationships with other bacteria, strengthening its potential association with LS hypopigmentation pathogenesis," said Associate Professor Yun Hak Kim in a press release.

Additionally, the team identified an abundance of Malassezia, a genus associated with hypopigmentation in other skin disorders, among LS patients with hypopigmentation.

This finding, particularly the presence of Malassezia restricta, points toward a potential link between Malassezia and LS hypopigmentation. Furthermore, Comamonas and Aspergillus were identified as other likely candidates.

The study suggests a relationship between an imbalance in the skin microbiota and LS-associated hypopigmentation, according to the press release. The frequency of Malassezia and C. acnes in hypopigmented LS cases indicates these could be novel treatment targets.

Looking ahead, the researchers propose future studies to explore temporal changes in the microbiome and observe the effects of antibiotic or antifungal agents on hypopigmentation frequency and duration. These investigations could provide insights into causative or correlative relationships between microbiome alterations and LS hypopigmentation, they said.

“Our findings provide promising avenues for further research to decipher the relationship between skin microbiota and LS hypopigmentation, ultimately aiming to elucidate novel therapeutic strategies," Kim said.

Reference

Pusan National University. PNU researchers reveal cutibacterium acnes as a potential cause of lichen striatus hypopigmentation. Published January 8, 2024. Accessed January 16, 2024. https://www.pusan.ac.kr/eng/CMS/Board/Board.do?mCode=MN104&mgr_seq=66&&mode=view&board_seq=1494088&